LigaSure for Management of Obstructed Hemivagina with Ipsilateral Renal Anomaly (OHVIRA) Syndrome

Abstract

Obstructed Hemivagina with Ipsilateral Renal Anomaly (OHVIRA) is a rare Mullerian anomaly of the female reproductive tract. This case presents a 12-year-old postmenarchal female who presented to the emergency department with abdominal pain for five days. On transvaginal ultrasound and pelvic computed tomography, she was found to have hematometrocolpos, uterine didelphys, complete right renal agenesis, and a right adnexal mass on imaging. Subsequent pelvic MRI confirmed the diagnosis of obstructed hemivagina and uterine didelphys, consistent with OHVIRA syndrome. Patient underwent a diagnostic vaginoscopy/hysteroscopy and vaginal septum resection using a LigaSure. This was followed by a diagnostic laparoscopy, and a left salpingo-oophorectomy was next performed for coinciding ovarian torsion. The patient was healing well without complaints by post-op day 12 and again during a phone call five months later. This case presents laparoscopic LigaSure as an option for gynecologists to manage and treat OHVIRA syndrome.